Development and Use of a New Staging System for Severe Acute Pancreatitis Based on a Nationwide Survey in Japan

Ogawa, Michio; Hirota, Masahiko; Hayakawa, Tetsuo; Matsuno, Seiki; Watanabe, Shinichiro; Ōtsuki, Makoto; Kashima, Kei; Koizumi, Masaru; Harada, Hideo; Yamamoto, Masahiro; Nishimori, Isao

doi:10.1097/00006676-200211000-00001

Cited by 86 publications

(81 citation statements)

References 7 publications

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“…Fulfillment of criterion 1 plus criterion 2 and/or 3 was required to make the diagnosis. Pancreatitis was graded as follows according to the scoring system proposed by the Ministry of Health, Labour and Welfare of Japan (JPN score) (28,29): mild (0 points); moderate (1 point); severe (2 points or more).…”

Section: Definitionmentioning

confidence: 99%

Prediction of Post-ERCP Pancreatitis

Nishino¹,

Toki²

2012

Pancreatitis - Treatment and Complications

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Section: Definitionmentioning

confidence: 99%

Prediction of Post-ERCP Pancreatitis

Nishino¹,

Toki²

2012

Pancreatitis - Treatment and Complications

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“…Post-ERCP pancreatitis was diagnosed in case of new onset or exacerbation of abdominal pain for >24 h which was associated with an increase in serum amylase level of at least three times greater than the upper limit of normal in the next morning. Acute pancreatitis was staged as severe (n = 2), moderate (n = 4), and mild (n = 28), according to a new staging system for acute pancreatitis [8]. Based on the previous data, APD patency was estimated in these 34 patients with post-ERCP pancreatitis.…”

Section: Methodsmentioning

confidence: 99%

A Patent Accessory Pancreatic Duct Prevents Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

Tabata

Kamisawa²,

Takuma³

et al. 2010

Dig Surg

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Background/Aim: Pancreatitis is the most common and feared complication of endoscopic retrograde cholangiopancreatography (ERCP). We previously examined patency of the accessory pancreatic duct (APD) by dye injection endoscopic retrograde pancreatography (ERP). APD patency was found in 43% of 291 control cases who had no particular changes in the head of the pancreas compared to only 6% in patients with acute pancreatitis. APD patency was closely related with the shape of the terminal portion of the APD. This study aimed to clarify whether patency of the APD prevents post-ERCP pancreatitis. Methods:We examined retrospectively the terminal shape of the APD by ERP in 34 patients with post-ERCP pancreatitis. Based on these data, patency of the APD was estimated from its terminal shape in patients with post-ERCP pancreatitis. Results: The stick-type APD (p < 0.01), which indicated high patency, was less frequent, and the branch-type APD (p < 0.01) and halfway-type APD, or no APD (p < 0.01), which showed quite low patency, were more frequent in patients with post-ERCP pancreatitis compared with controls. Accordingly, the estimated patency of the APD in post-ERCP pancreatitis patients was only 16%, which was significantly lower than the 43% in controls. There was no significant relationship between the estimated APD patency and the severity of post-ERCP pancreatitis. Conclusions: The estimated APD patency was significantly lower in patients with post-ERCP pancreatitis. A patent APD may function as a second drainage system to reduce the pressure in the main pancreatic duct and prevent post-ERCP pancreatitis.

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“…The duration of abdominal pain in the CRAI group was 1.9 ± 0.26 d (range, 1-3), whereas the duration in the non-CRAI group was 4.3 ± 0.50 (range, [3][4][5][6][7][8]. Abdominal pain disappeared significantly in a short period of time after the initiation of CRAI with the protease inhibitor (P = 0.0005, Figure 1A).…”

Section: Duration Of Abdominal Pain Sirs and Hospitalizationmentioning

confidence: 96%

“…The severity of acute pancreatitis was assessed within 48 h of admission according to the diagnostic criteria for the diagnosis of acute pancreatitis by the Research Committee for Intractable Diseases of the Pancreas in Japan by Ministry of Health, Labour and Welfare Japan (Tables 1 and 2) [4][5][6] . A total of 18 patients fulfilling clinical diagnostic criteria for SAP at six participating institutions were selected for the present study.…”

Section: Patientsmentioning

confidence: 99%

Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis

Ino

Arita

Akashi

et al. 2008

WJG

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AIM:To evaluate the efficacy of continuous regional arterial infusion therapy (CRAI) with gabexate mesilate and antibiotics for severe acute pancreatitis (SAP). METHODS:We conducted a prospective study on patients who developed SAP with or without CRAI. Out of 18 patients fulfilled clinical diagnostic criteria for SAP in Japan, 9 patients underwent CRAI, while 9 patients underwent conventional systemic protease inhibitor and antibiotics therapy (non-CRAI). CRAI was initiated within 72 h of the onset of pancreatitis. Gabexate mesilate (2400 mg/d) was continuously administered for 3 to 5 d. The clinical outcome including serum inflammation-related parameters were examined. RESULTS: The duration of abdominal pain in the CRAI group was 1.9 ± 0.26 d, whereas that in the non-CRAI group was 4.3 ± 0.50. The duration of SIRS in the CRAI group was 2.2 ± 0.22 d, whereas that in the non-CRAI group was 3.2 ± 0.28. Abdominal pain and SIRS disappeared significantly in a short period of time after the initiation of CRAI using gabexate mesilate. The average length of hospitalization significantly differed between the CRAI and non-CRAI groups, 53.3 ± 7.9 d and 87.4 ± 13.9 d, respectively. During the first two weeks, levels of serum CRP and the IL6/IL10 ratio in the CRAI group tended to have a rapid decrease compared to those in the non-CRAI group. CONCLUSION: The present results suggest that CRAI using gabexate mesilate was effective against SAP.

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Development and Use of a New Staging System for Severe Acute Pancreatitis Based on a Nationwide Survey in Japan

Abstract: We found that stage at hospitalization reflected the prognosis of acute pancreatitis.

Cited by 86 publications

References 7 publications

Prediction of Post-ERCP Pancreatitis

Prediction of Post-ERCP Pancreatitis

A Patent Accessory Pancreatic Duct Prevents Pancreatitis following Endoscopic Retrograde Cholangiopancreatography

Continuous regional arterial infusion therapy with gabexate mesilate for severe acute pancreatitis

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